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01.12.2015 | Research article | Ausgabe 1/2016 Open Access

BMC Public Health 1/2016

Missouri K-12 school collection and reporting of school-based syndromic surveillance data: a cross sectional study

BMC Public Health > Ausgabe 1/2016
Terri Rebmann, Allison K. Kunerth, Alan Zelicoff, Michael B. Elliott, Harper F. Wieldt
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

TR participated in all aspects of this study from design and data collection to analysis and manuscript writing. AK participated in data cleaning and analysis, and manuscript writing. AZ helped to draft the manuscript. ME oversaw and assisted with data analysis. HW participated in data analysis and helped to draft the manuscript. All authors read and approved the final manuscript.



School participation in collecting and reporting syndromic surveillance (SS) data to public health officials and school nurses’ attitudes regarding SS have not been assessed.


An online survey was sent to Missouri Association of School Nurses members during the 2013/2014 school year to assess whether K-12 schools were collecting and reporting SS data. Z-scores were used to assess collection versus reporting of SS indicators. Logistic regressions were used to describe factors predicting nurses’ collection and reporting of SS indicators: all-cause absenteeism, influenza-like illness and gastrointestinal illness. Univariate predictors were assessed with Chi-Squares.


In total, 133 school nurses participated (33.6 % response rate). Almost all (90.2 %, n = 120) collect at least one SS indicator; half (49.6 %, n = 66) report at least one. Schools are collecting more SS data than they are reporting to the health department (p < .05 for all comparisons). Determinants of school nurses’ collection of SS data included perceived administrative support, and knowledge of collecting and analyzing SS data. The strongest predictive factors for reporting SS data were the perception that the health department was interested in SS data and being approached by the health department to collect SS data.


Schools are collecting SS indicators at a relatively high rate, yet less than half of the data is reported to public health officials. Findings from this study indicate that public health officials can increase access to school-based SS data by approaching schools about collecting and reporting this important data.
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